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Friday, May 18, 2018

Significant progress and improvement reported in state office investigating elder abuse complaints

The Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS) this week provided an update on the progress of the inter-agency partnership to improve the performance of the program that investigates reports of elder abuse and maltreatment.

Minnesota Commissioner of Health Jan Malcolm praised the contributions of DHS as well as the efforts of MDH's Office of Health Facility Complaints (OHFC) staff and managers for implementing a broad set of improvements, ranging from new electronic tools to stronger communication and oversight.

The MDH/DHS partnership formed in late 2017 to address the significant performance shortfalls documented in OHFC. When the inter-agency team started its work in early January 2018, there was a backlog of 2,321 reports awaiting triage and 826 triaged cases awaiting investigation. By the end of February, the team had completed triage review of all reports in the 2017 triage backlog and greatly reduced the investigation backlog. In the latest progress report posted on the Office of Health Facility Complaints Quality Improvement Project website this week, that investigation backlog had been reduced to 122.

Among the other accomplishments to report:

  • All maltreatment reports now have an initial review within two days to screen for imminent and continued risk to vulnerable adults.
  • OHFC implemented a new electronic document management system for receiving, handling and investigating elder abuse complaints. OHFC staff no longer rely on paper documents as part of the complaint process, thereby increasing efficiency.
  • The inter-agency team implemented changes to help ensure better supervision of staff performing intake, triage and investigations. This includes documented processes and performance metrics that help monitor staff work output, enabling supervisors to more effectively manage the performance of individual staff and teams.
  • The team created a public dashboard to document the status and progress of our effort. This dashboard is updated weekly and posted on the Office of Health Facility Complaints Quality Improvement Project website.
  • OHFC continues to refine improved standard work processes in multiple areas, using OHFC and DHS Office of Inspector General subject matter experts.
  • OHFC implemented new processes to allow in-office follow-ups by investigators, thereby reducing travel time that staff had spent previously as part of mandatory on-site follow-ups regardless of severity of the deficiency.
  • The inter-agency team is working with OHFC supervisors to streamline and document the supervisory reviews of investigations. Standards for supervisory review step did not exist previously, making the process inconsistent and inefficient.
  • The team facilitated weekly human resources training for supervisors and mentoring on effectively supervising a paperless process.
  • OHFC is streamlining and improving the quality and clarity of the letters it sends to complainants and families.
  • OHFC implemented an interim technology solution and electronic fax technology, eliminating antiquated paper-based systems and improving efficiency and accountability.
  • The inter-agency team is working with Minnesota Information Technology Services to develop a long-term technology solution and to document business practices.
  • Using a request for information process, MDH solicited stakeholder feedback on specifications and functions of a new electronic case management systemto replace the antiquated system currently in use. The department received 20 responses that will help ensure a modern, highly functioning case management system is put in place.
  • The inter-agency team reorganized the OHFC workspace to better support paperless processes and effective performance management.

"These accomplishments are encouraging steps in a larger process to ensure an effective and timely response to every complaint we receive," Commissioner Malcolm said. "We look forward to continuing to improve our regulatory oversight. We also reiterate the need for the Legislature to come to the table to address larger issues of reforming the long-term care industry to ensure the dignity and safety for all our seniors."

Governor Dayton proposed a package of reforms in March 2018 that dovetailed with the recommendations of the Office of the Legislative Auditor and the recommendations of the group convened by AARP. His proposal strengthens the state's regulatory system while also tackling the broader issue of elder abuse. The reforms focus on prevention, quality improvement, greater accountability for care providers and stronger protections for seniors.

-MDH-

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